• The Journal of Advanced Prosthodontics
• /
• v.13 no.6
• /
• pp.373-384
• /
• 2021

PURPOSE. This study aimed to compare the marginal and internal fit of 3-unit monolithic zirconia restorations that were designed by using the data obtained with the aid of intraoral and laboratory scanners. MATERIALS AND METHODS. For the fabrication of 3-unit monolithic zirconia restorations using impressions taken from the maxillary master cast, plaster cast was created and scanned in laboratory scanners (InEos X5 and D900L). The main cast was also scanned with different intraoral scanners (Omnicam [OMNI], Primescan [PS], Trios 3 [T3], Trios 4 [T4]) (n = 12 per group). Zirconia fixed partial dentures were virtually designed, produced from presintered block, and subsequently sintered. Marginal and internal discrepancy values (in ㎛) were measured by using silicone replica method under stereomicroscope. Data were statistically analyzed by using 1-way ANOVA and Kruskal Wallis tests (P<.05). RESULTS. In terms of marginal adaptation, the measurements on the canine tooth indicated better performance with intraoral scanners than those in laboratory scanners, but there was no difference among intraoral scanners (P<.05). In the premolar tooth, PS had the lowest marginal (86.9 ± 19.2 ㎛) and axial (92.4 ± 14.8 ㎛), and T4 had the lowest axio-occlusal (89.4 ± 15.6 ㎛) and occlusal (89.1 ± 13.9 ㎛) discrepancy value. In both canine and premolar teeth, the D900L was found to be the most marginally and internally inconsistent scanner. CONCLUSION. Within the limits of the study, marginal and internal discrepancy values were generally lower in intraoral scanners than in laboratory scanners. Marginal discrepancy values of scanners were clinically acceptable (< 120 ㎛), except D900L.

• The Journal of Korean Academy of Prosthodontics
• /
• v.57 no.3
• /
• pp.263-270
• /
• 2019

Current trends in restorative dentistry focus on improving the esthetics and keeping the sound dental tissues as long as possible. The aims of this case report were to describe the successful outcome of cubic-phase zirconia laminate veneers for a patient with isolated microdontia by using a digital workflow, and to describe their clinical implications. A 15-year-old female who had isolated microdontia in combination with spacing visited Ajou University Dental Hospital for esthetic treatment. In this case, 6 maxillary anterior teeth were restored with cubic-phase zirconia laminate veneers without tooth structure removal by using a digital impression, computer-aided design (CAD) software, and computer-aided manufacturing (CAM) procedures. At 6-month follow-up, no distinct mechanical and biological complications were detected and the prostheses exhibited satisfactory esthetics and functions. Due to its favorable tissue responses and enhanced translucency, cubic-phase zirconia can be a suitable strategy for a noninvasive esthetic approach.

• The Journal of Korean Academy of Prosthodontics
• /
• v.59 no.1
• /
• pp.71-78
• /
• 2021

Implant treatment, which was first attempted in fully edentulous patients, is now widely used in partially edentulous, and a single tooth missing patients. Moreover, implant treatment has become an essential treatment modality in modern dentistry. The material of fabricating implant prostheses has also become more diverse than before, one of which is the use of high-performance polymers. The frequency of using high-performance polymers, which have been used in the medical field, is also increased in the dental field compared to the past. In the first case, a PEKK abutment and a PFG crown (cement-screw-retaining type) were fabricated in the lower left second premolar, and in the second case, a PEKK abutment and a monolithic zirconia crown (cement-screw-retaining type) were fabricated in the missing upper left first molar, and in the third case two PEKK abutments and a splinted PFM crowns (cement-screw-retaining type) were fabricated and connected to the upper right first and second molar implants. Through these procedures the patients obtained esthetically and functionally satisfactory results after 4 years of follow-up.

• Journal of Korean Dental Science
• /
• v.12 no.1
• /
• pp.13-19
• /
• 2019

Purpose: The aim of this study was to compare the flexural strength of provisional fixed dental prostheses which was three-dimensional (3D) printed by several build directions. Materials and Methods: A metal jig with two abutment teeth and pontic space in the middle was fabricated. This jig was scanned with a desktop scanner and provisional restoration was designed on dental computer-aided design program. On the preprocessing software, the build angles of the restorations were arranged at $0^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, and $90^{\circ}$ and support was added and resultant structure was sliced to a thickness of $100{\mu}m$. Processed restorations were printed with digital light processing type 3D printer using poly methyl meta acrylate-based resin. After washing and post-curing, compressive loading was applied at a speed of 1 mm/min on a metal jig fixed to a universal testing machine. The maximum pressure at which fracture occurred was measured. For the statistical analysis, build direction was set as the independent variable and fracture strength as the dependent variable. One-way analysis of variance and Tukey's post hoc analysis was conducted to compare fracture strength among groups (${\alpha}=0.05$). Result: The mean flexural strength of provisional restoration 3D printed with the build direction of $0^{\circ}$ was $1,053{\pm}168N$; it was $1,183{\pm}188N$ at $30^{\circ}$, $1,178{\pm}81N$ at $45^{\circ}$, $1,166{\pm}133N$ at $60^{\circ}$, and $949{\pm}170N$ at $90^{\circ}$. The group with a build direction of $90^{\circ}$ showed significantly lower flexural strength than other groups (P<0.05). The flexural strength was significantly higher when the build direction was $30^{\circ}$ than when it was $90^{\circ}$ (P<0.01). Conclusion: Among the build directions $0^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, and $90^{\circ}$ set for 3D printing of fixed dental prosthesis, an orientation of $30^{\circ}$ is recommended as an effective build direction for 3D printing.

• Imaging Science in Dentistry
• /
• v.45 no.1
• /
• pp.41-47
• /
• 2015

Purpose: This study was performed to evaluate the linear distance accuracy and reliability of stitched small field of view (FOV) cone-beam computed tomography (CBCT) reconstructed images for the fabrication of implant surgical guides. Material and Methods: Three gutta percha points were fixed on the inferior border of a cadaveric mandible to serve as control reference points. Ten additional gutta percha points, representing fiduciary markers, were scattered on the buccal and lingual cortices at the level of the proposed complete denture flange. A digital caliper was used to measure the distance between the reference points and fiduciary markers, which represented the anatomic linear dimension. The mandible was scanned using small FOV CBCT, and the images were then reconstructed and stitched using the manufacturer's imaging software. The same measurements were then taken with the CBCT software. Results: The anatomic linear dimension measurements and stitched small FOV CBCT measurements were statistically evaluated for linear accuracy. The mean difference between the anatomic linear dimension measurements and the stitched small FOV CBCT measurements was found to be 0.34 mm with a 95% confidence interval of +0.24 - +0.44 mm and a mean standard deviation of 0.30 mm. The difference between the control and the stitched small FOV CBCT measurements was insignificant within the parameters defined by this study. Conclusion: The proven accuracy of stitched small FOV CBCT data sets may allow image-guided fabrication of implant surgical stents from such data sets.

• The Journal of Advanced Prosthodontics
• /
• v.12 no.4
• /
• pp.225-232
• /
• 2020

PURPOSE. This study aimed to fabricate provisional crowns at varying build directions using the digital light processing (DLP)-based 3D printing and evaluate the marginal and internal fit of the provisional crowns using the silicone replica technique (SRT). MATERIALS AND METHODS. The prepared resin tooth was scanned and a single crown was designed using computer-aided design (CAD) software. Provisional crowns were printed using a DLP-based 3D printer at 6 directions (120°, 135°, 150°, 180°, 210°, 225°) with 10 crowns in each direction. In total, sixty crowns were printed. To measure the marginal and internal fit, a silicone replica was fabricated and the thickness of the silicone impression material was measured using a digital microscope. Sixteen reference points were set and divided into the following 4 groups: marginal gap (MG), cervical gap (CG), axial gap (AG), and occlusal gap (OG). The measurements were statistically analyzed using one-way ANOVA and Dunnett T3. RESULTS. MG, CG, and OG were significantly different by build angle groups (P<.05). The MG and CG were significantly larger in the 120° group than in other groups. OG was the smallest in the 150° and 180° and the largest in the 120° and 135° groups. CONCLUSION. The marginal and internal fit of the 3D-printed provisional crowns can vary depending on the build angle and the best fit was achieved with build angles of 150° and 180°.

• The Journal of Advanced Prosthodontics
• /
• v.15 no.1
• /
• pp.44-54
• /
• 2023

PURPOSE. To assess the clinical performance of monolithic CAD-CAM lithium disilicate glass-ceramic (LDGC) crowns and metal-ceramic (MC) crowns provided by predoctoral students. This study also assessed the effects of patient and provider-related factors on their clinical performance as well as patient preference for these types of crowns. MATERIALS AND METHODS. Twenty-five patients who received 50 crowns (25 LDGC CAD-CAM and 25 MC) provided by predoctoral students were retrospectively examined. LDGC CAD-CAM crowns were milled in-house using the CEREC Bluecam system and cemented with either RelyX Unicem or Calibra Esthetic resin cements. MC crowns were cemented with RelyX Unicem cement. Clinical assessment of the crowns and the supporting periodontal structures were performed following the modified California Dental Association (CDA) criteria. Patients' preference was recorded using a visual analog scale (VAS). The results were statistically analyzed using log-rank test, Pearson Chi-squared test and Kaplan-Meier survival analysis. RESULTS. Twelve complications were observed in the MC crown group (9-esthetic, 2-technical and 1-biological). In comparison, 2 complications in the LDGC CAD-CAM crown group were observed (1-technical and 1-esthetic). The 6-year cumulative survival rates for MC crowns and LDGC CAD-CAM were 90.8% and 96%, respectively, whereas the success rates were 83.4% and 96%, respectively. Overall, patients preferred the esthetic outcomes of LDGC CAD-CAM crowns over MC crowns. CONCLUSION. The high survival and success rates, low number of complications, and the high level of patients' acceptance of monolithic LDGC CAD-CAM crowns lend them well as predictable and viable alternatives to the "gold standard" MC crowns.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.28 no.4
• /
• pp.423-439
• /
• 2012

This case report described a technique utilizing a computer-aided design (CAD)/computer-aided machining (CAM) - guided surgical implant placement and prefabricated temporary fixed prosthesis for an immediately loaded restoration. The advantages of CAD/CAM guided implant procedures are flapless, minimally invasive surgery and shorter surgery time. With this technique, less postoperative morbidity and delivery of prosthesis for immediate function would be possible. A patient with an edentulous maxilla received 8 implants in maxilla using CAD/CAM surgical templates. Prefabricated provisional maxillary implant supported fixed prosthesis were connected immediately after implant installation. Provisional prosthesis was evaluated for aesthetics, function during 6 months. Definitive implant supported fixed porcelain fused metal bridges were fabricated.

• The Journal of Advanced Prosthodontics
• /
• v.14 no.3
• /
• pp.150-161
• /
• 2022

PURPOSE. The purpose of the study was to assess the influence of build orientations and density of support structures on the trueness of the 3D printed removable partial denture (RPD) frameworks. MATERIALS AND METHODS. A maxillary Kennedy class III and mandibular class I casts were 3D scanned and used to design and produce two 3D virtual models of RPD frameworks. Using digital light processing (DLP) 3D printing, 47 RPD frameworks were fabricated at 3 different build orientations (100, 135 and 150-degree angles) and 2 support structure densities. All frameworks were scanned and 3D compared to the original virtual RPD models by metrology software to check 3D deviations quantitatively and qualitatively. The accuracy data were statistically analyzed using one-way ANOVA for build orientation comparison and independent sample t-test for structure density comparison at (α = .05). Points study analysis targeting RPD components and representative color maps were also studied. RESULTS. The build orientation of 135-degree angle of the maxillary frameworks showed the lowest deviation at the clasp arms of tooth 26 of the 135-degree angle group. The mandibular frameworks with 150-degree angle build orientation showed the least deviation at the rest on tooth 44 and the arm of the I-bar clasp of tooth 45. No significant difference was seen between different support structure densities. CONCLUSION. Build orientation had an influence on the accuracy of the frameworks, especially at a 135-degree angle of maxillary design and 150-degree of mandibular design. The difference in the support's density structure revealed no considerable effect on the accuracy.

• The Journal of Advanced Prosthodontics
• /
• v.15 no.5
• /
• pp.227-237
• /
• 2023

PURPOSE. This study aimed to assess and compare the color stability, flexural strength (FS), and surface roughness of occlusal splints fabricated from heat-cured acrylic resin, milled polymethyl methacrylate (PMMA)-based resin, and 3D-printed (PMMA) based-resin. MATERIALS AND METHODS. Samples of each type of resin were obtained, and baseline measurements of color and surface roughness were recorded. The specimens were divided into three groups (n = 10) and subjected to distinct aging protocols: thermomechanical cycling (TMC), simulated brushing (SB), and control (without aging). Final assessments of color and surface roughness and three-point bending test (ODM100; Odeme) were conducted, and data were statistically analyzed (2-way ANOVA, Tukey, P <.05). RESULTS. Across all resin types, the most significant increase in surface roughness (Ra) was observed after TMC (P < .05), with the 3D-printed resin exhibiting the lowest Ra (P < .05). After brushing, milled resin displayed the highest Ra (P < .05) and greater color alteration (∆E₀₀) compared to 3D-printed resin. The most substantial ∆E₀₀ was recorded after brushing for all resins, except for heat-cured resin subjected to TMC. Regardless of aging, milled resin exhibited the highest FS (P < .05), except when compared to 3D-printed resin subjected to TMC. Heat-cured resin exposed to TMC demonstrated the lowest FS, different (P < .05) from the control. Under control conditions, milled resin exhibited the highest FS, different (P < .05) from the brushed group. 3D-printed resin subjected to TMC displayed the highest FS (P < .05). CONCLUSION. Among the tested resins, 3D-printed resin demonstrated superior longevity, characterized by minimal surface roughness and color alterations. Aging had a negligible impact on its mechanical properties.